Stopping the opioid epidemic means smarter prescribing

published on July 27, 2017 by Evan Wood in The Globe and Mail

Evan Wood is the director of the B.C. Centre on Substance Use and a professor of medicine and Canada Research Chair at the University of British Columbia.

One of the confusing ironies of addressing the opioid crisis is that halting overdose deaths will require stopping prescribing for some, while actively prescribing opioids to others.

Having spent the past year being centrally involved in the response to British Columbia’s overdose crisis, I’m always surprised when I hear people question the role of prescription opioids in the fatal overdose epidemic.

The shenanigans of the pharmaceutical industry in promoting opioid drugs as safe have been clearly exposed, and the deadly effects of over-prescription in areas where marketing strategies were most intense have also been well documented.

West Virginia, which the U.S. Centers for Disease Control and Prevention ranked as the U.S. state with the highest rate of opioid-overdose deaths, was blanketed with almost 800 million potent hydrocodone and oxycodone pills over a six-year period. A single pharmacy in Kermit, a town of a population of less than 400, was found to have received more than nine million hydrocodone pills over a two-year period.

Of course, careless dispensing of opioids from pharmacies requires careless prescribing by physicians who have clearly not understood the safety concerns with opioid drugs and the potential for abuses. Consider the case of a British Columbian patient documented to have received more than 23,000 oxycodone pills through more than 50 physicians and 100 pharmacies before authorities finally became aware.

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